What's your opinion on a second opinion? :-)

[Ged1975]

I was thinking about getting a second opinion on my aortic valve leak i.e. I will get an independent echo.

My lastest echo was last September and from those results the hospital thought it was time I should get a valve replacement.

I thought it was strange that they base this decision on one echo. The results showed I had moderate leaking.

Would you advise I get a second opinion?

 

[debster913]

Gerard,
Glad to see you vack on! Yes, a second opinion is always a good idea. When I had my surgery, my cardiologist ran several diagnostic tests (echo, angiogram, TEE, and even a pulmonary function test to rule out asthma) before he sent me to the surgeon. My surgeon took one look at all those tests and said I needed surgery right away. By the way, according to my cardio, my valve only showed "moderate" leakage. Each test revealed something different, and my cardio wasn't quite convinced I needed surgery that badly. I did, though--I was having terrible symptoms! The surgeon looked at those tests and thought my cardio was being too conservative in his assessment--my valve was in bad shape.

It is quite interesting that your doctor based his decision on only an echo. Many times before sending their patients to surgery, cardios like to run several tests first.

Get the opinion of another surgeon. Hopefully this will ease your mind.

Best,
Debi (debster913)

 

[deano89]

Hi Ged have you had TEE or just echo ?i know the TEE gave a much better look at my valve and heart and did show that the first echo was not as accurate but they are still recommending surgery,think your probably like me you want to here the words, you dont need surgery just yet but sometime in the future ,i know there the words i was hoping to here! ,but if a second opinion will help you come to terms with this situation why not , i also know from everthing i have read and have been told by my doctors that its important to have truly elective surgery before any long term damage is done to the heart
Dean

 

[Jkm7]

I definitely would request another echo, TEE and possbily a cath.
My cardio told me flat out he had reviewed my records with other doctors in his group. I respect all of them as they all have excellent reputation and when he told me they were all in agreement, I called that my second, third and fourth opinions. Knowing they all agreed was very comforting to me.

If it were me, I would not settle for waiting. I'd want more testing and opinions now (or soon.)

 

[Lisa in Katy]

It depends. I didn't have a second opinion, but then there wasn't a question about my surgery. I'd known for 22 years that I would need it eventually. If you are thinking you will get a second opinion, and that doctor will tell you that you are perfectly healthy and will never need surgery, you are probably wrong. However, if it will ease your mind, I would say do it, but don't wait too long. Don't use that as an excuse to delay because the longer you wait, the worse the damage could be.

The only TEEs I've ever had were shortly after surgery when I was still under the anesthesia. BTW, how do they do it with the vent still in? I had annual (or more often) echos up to the surgery. I also had a cath about 2 months before. Even though an echo is a good test, I don't think it's usually the only test before surgery.

 

[escargome]

Hi Gerard,
Glad to see you posting again. Yes, a second, or even maybe a third opinion would not hurt. You know what they say opinions are like belly-buttons, everyone has one. So get tested and listen to the opinions that are offered. Just try not to wait too long. God Bless You

 

[Marguerite53]

Hello! Happy to see you!

Here in the States it is very different, I think. My surgeon would not consider doing surgery until he had seen my heart cath or angiogram. That gave him the information they needed to go ahead -- lots of important measurements. My TEE was done immediately before my surgery (as in I have no memory of it, but I know it was done).

I would not think that another echo would tell you much that you need to know at this point since the hospital is already thinking surgery time. Perhaps they are not discussing your case fully with you, or you are missing an important point about why they want to go in now.

Let us know if these other important tests have been performed. If so, then get those results and go consult another surgeon independently.

Best wishes.

Marguerite

 

[kfay]

Ged, If it will put your mind at ease, by all means get a second opinion. However, knowing how your system works, I seriously doubt they would recommend that you have surgery unless it was absolutely time.

Glad you came back on here and hopefully, we can be of some support to you.

Kim

 

[Nupur]

Yes, absolutely! Second, third, as many as you need to make a decision. TEE is probably a very good idea. Doctors within a practice might consult with each other anyway. I am surprised that you were in pre-op without a TEE or heart cath?

Glad you are here asking questions : )

 

[Lisa in Katy]

Yes, absolutely! Second, third, as many as you need to make a decision. TEE is probably a very good idea. Doctors within a practice might consult with each other anyway. I am surprised that you were in pre-op without a TEE or heart cath?

Glad you are here asking questions : )

Multiple opinions might be something you can do in the US, but in Ireland, unless you are willing to pay for it out of your pocket, I'm not sure how many they would allow. Also, the medical system moves much slower there and it might take many months, if not years.

 

[deano89]

uk is definetly different ...i was told heart cath was basically only done on me because i was over 45 ,But TEE is always done if surgery is likely also time yes very slooooooow my journey started back in july 08 and first echo where decided i needed surgery was in october since then its taken this long to get TEE ,heart cath and cardio appointments approx 8 weeks between each test and cardio visits, now i am down to see surgeon on 27 april which is 71/2 weeks after heart cath .so yes the wheels turn very slowly but i think this only seems to happen for mitral valve!!
so Ged if you are going for 2nd opinion push hard to get it done ASAP
Dean

 

[Nupur]

Well, even if my top of the line PPO insurance here in the US, it is a pain to find a second opinion : ) When I wanted to see a second cardiologist, they kept telling me I needed a referral from my GP and I got frustrated. I asked for a copy of my echo tape from the first cardio's office, got it after paying $25, drove it to the second cardio's office and said "Here, ask your doc to take a look, this is much better referral than a FAX from my GP" and they let me make an app.

I don't know how expensive it is to pay out of pocket for at least a consult. Given how much mental agony Gerard has undergone with preparing for surgery, it might just be worth it. All the best!

 

[Lynlw]

Well, even if my top of the line PPO insurance here in the US, it is a pain to find a second opinion : ) When I wanted to see a second cardiologist, they kept telling me I needed a referral from my GP and I got frustrated. I asked for a copy of my echo tape from the first cardio's office, got it after paying $25, drove it to the second cardio's office and said "Here, ask your doc to take a look, this is much better referral than a FAX from my GP" and they let me make an app.

I don't know how expensive it is to pay out of pocket for at least a consult. Given how much mental agony Gerard has undergone with preparing for surgery, it might just be worth it. All the best!

WOW I never had to get referals with our PPO plans, that is one of the reason I chose it over the HMO because we didn't need referals.

 

[Megan]

i just had second opinion-it was fully covered by my insurance- a PPO -but they required a referral from my cardiologist. In any event, I wanted it for peace of mind and they did a repeat echo of their own and got the same #s and advice so it gave me tremendous peace knowing I was headed in the right direction. Echo is the less reliable measure of gradient and valve area compared to TEE or angiogram(cath). The standard practice in the states is to confirm measurements by either cath or tee or both then surgery. good luck!

 

[sue943]

It didn't occur to me to ask for a second opinion, I had total confidence in what I was told. To be honest if I had asked for a second opinion and that differed to the original opinion then I wouldn't know who to believe and would need a third opinion - where does one stop? Time would have marched on and it could have been dangerous to seek further opinions and to not just get on with it.

I was discharged from hospital after my endocarditis in the latter part of April, was given a few weeks to see how I was getting on, not very well as it happened, then cath early June and surgery late June. The first TOE was during my hospitalisation in March/April then a second when I was on the table so the surgeon could decide on one or two valves.

So I wouldn't have liked to have had a second opinion, but that is just my own opinion and you need to go with what you are happy with. If you get differing opinions do you follow the one that you WANT to hear even if that isn't actually the best option?

 

[MikeHeim]

Second opinions can be a mixed bag. I personally believe that if you are comfortable with your first opinion and the person giving it to you, then you should go with it. If not, get a second one. I know some people around here think you should automatically get a second opinion. Such a plan works out great if the doctors come to the same conclusion, but it leaves you in a difficult spot if they do not. What do you do then? Get a third opinion? What's going to make you pick one opinion over the other?

 

[ALCapshaw2]

I'm a Big Believer in Multiple Opinions before surgery.

That said, once a diagnosis has been made, I like to get opinions from SURGEONS who would seem to have a better perspective (IMO).

Edit: <SNIP>

Bottom Line: I would recommend a second opinion from a Surgeon but get a Cath / Angiogram before meeting the surgeon so that he will know the full state of your heart.

 

[lilteach3234]

I knew I had a bad aortic valve and only had a matter of a few months before I'd need surgery. I then had a transcient global amnesia attack (TGA and not a TIA). After loads of testing, the echo is the only thing that showed something.

I went to my regular cardiologist who said I needed immediate surgery. Realizing I did not want to be in a hospital on the outskirts of Houston, I did some homework and got myself to the Texas Medical Center where I got one of the best surgeons and cardiologists.

We arranged immediate surgery and it was a good thing.....I was a walking, ticking, time bomb.

If time permits, I'd do my homework and get a couple of opinions.

I am truly blessed and very lucky right now!

 

[Bridgette]

Where are you going to go and get your second opinion from Ged? Are you going to go across to England?

 

[westie]

faith

faith

.
I asked our GP if i should get a second opinion from a surgeon. he said that was quite normal and that he would be happy to give me a referal, "BUT, the second and third opinions will all be diferent and you will end up in a mess trying to decide what to do. All you can do is choose a surgeon, put your faith in him and back him 100%"

So I asked the GP if the surgeon I has seen was good; he said "Westie, he is the best." I ended up trusting my GP and surgeon 100% and have no regrets.

It seems you have had a number of echos which surely all show that you really do have a heart problem; so the real question must be should you have an operation in 1 year or 2 years etc? Really, it will not be the end of the world if you have the operation one year early because early is better than later.